Matching Grant Application The Rotary Foundation (TRF) PROJECT DESCRIPTION Explanation: Matching Grants support the humanitarian service projects of Rotary clubs and districts. In this section, describe in detail the humanitarian need your project will address, the intent of the project, how the project will be implemented, and how Rotarians will be directly involved in the project. Involvement is required of both the host and international partners. Please provide the name of the project site, the city or village, state or province, and country. List multiple locations, if applicable. Project site City/Village State/Province Country Cristo Redentor Parish Tijuana Baja California Mexico Describe the project and the problem or need it will address, including the intended beneficiaries and how the project will benefit the community in need. Provide the estimated length of time needed to complete the project. The 450 students of Saint Rose of Lima School in Tijuana, Mexico have an urgent need of a van for transportation to the many academic, cultural, civic, religious, and sporting events that are part of their school activities. Listed below are the planned activities for this year for which transportation will be needed: Interscholastic Testing Science and Techology Projects History and Geography of Baja California Competition The National Anthem Competition Public Speaking Competition Marching Competition Visits to the Cultural Center of Tijuana Visits to the Government Centers Visits to the University campuses Participation in different Religious and Cultural Events Sporting Competition between schools Outings and other Field Trips The van is also needed for transporting the students to the dentist, local hospital or urgent care clinics in case of sickness or accidents. A secondary use will be to help the teachers attend continuing education classes, meetings at the District Office of Education to ensure compliance with zone requirements mandated by the state of Baja California, and provide transportation for when they need to go shopping for materials for the students. Describe how the benefiting community will maintain this project after grant funding has been fully expended.
Colegio Santa Rosa de Lima is funded soley by donations from individuals and private organizations. Such donations will fund the purchase of gasoline and maintenance during the life of the vehicle. Describe specific activities of the host and international partners in implementing the project. What will the Rotarians who are members of the partner clubs do during the project? Please note that financial support is not considered active involvement. (See the Matching Grant application instructions for suggestions.) The host and international partner will arrange the purchase of the appropriate van and work together in presenting the van to the school, along with all applicable recognitions to TRF.
HOST PARTNER Explanation: The host partner is the club or district in the project country. A committee of at least three Rotarians must be established to oversee the project. The primary project contact must be a member of the primary club identified below. The project committee must be composed of members of the sponsor Rotary clubs for club-sponsored projects or district for districtsponsored projects. The committee members must be committed for the duration of the grant process. Please provide the primary address for all committee members, as all Rotary information will be sent to this address. It is highly recommended that the primary contact (who receives all information from TRF) have an e-mail address to expedite communication. Primary Club/District Club: Ensenada Calafia Club ID number (if known): 31897 District: 4100 Country: Mexico Primary Contact: Name: M. Ofelia Diaz Perea Member ID: 3368542 Club: Ensenada Calafia Rotary Position: COMUNITY / INTERNATIONALSERVICE Address: obregon y 10#285-7, centro City: ensenada State/Province: baja california Postal code: 22800 Country: Mexico Email: ecintegral@hotmail.com Home phone: 52+6461745201 Office phone: 52+6461753685 Fax: 52+6461786250 Project Contact #2: Name: LUIS JUAREZ LUJAN Member ID: 5975195 Club: Ensenada Calafia Rotary Position: PRESIDENT Address: OBREGON #844 City: ENSENDA State/Province: BAJA CALIFORNIA Postal code: 22800 Country: Mexico Email: lujua55@hotmail.com Home phone: 52+6461744650 Office phone: 52+6461781528 Fax: 52+6461781528 Project Contact #3: Name: ARTURO VILLAVICENCIO Member ID: Club: Ensenada Calafia Rotary Position: ROTARY FOUNDATION COMITEE Address: LIBERTAD #480,MAESTROS City: ENSENADA, State/Province: BAJACALIFORNIA Postal code: 22870 Country: Mexico Email: arturovillavicencio@hotmail.com Home phone: 52+6469479045 Office phone: 52+6461771781 Fax: 52+6461768801
INTERNATIONAL PARTNER Explanation: The international partner is the club or district outside the project country. A committee of at least three Rotarians must be established to oversee the project. The primary project contact must be a member of the primary club identified below. The project committee must be composed of members of the sponsor Rotary clubs for club-sponsored projects or district for district-sponsored projects. The committee members must be committed for the duration of the grant process. Please provide the primary address for all committee members, as all Rotary information will be sent to this address. It is highly recommended that the primary contact (who receives all information from TRF) have an e-mail address to expedite communication. Primary Club/District Club: Coronado District: 5430 Country: USA Club ID number (if known): Primary Contact: Name: Ron Vernetti Member ID: Club: Coronado Rotary Position: Member Address: 1115 F Avenue City: Coronado State/Province: CA Postal code: 92118 Country: USA Email: ronvernetti@yahoo.com Home phone: 619-435-1760 Office phone: None Fax: None Project Contact #2: Name: Dan Gensler Member ID: Club: Coronado Rotary Position: District Maatching Grant Chairman Address: 120 C Avenue City: Coronado State/Province: CA Postal code: 92118 Country: USA Email: dan@genslergroup.com Home phone: 619-435-6114 Office phone: 619-230-0545 Fax: 619-230-1881 Project Contact #3: Name: Barry Thomas Member ID: Club: Coronado Rotary Position: International Services Director Address: 45 Spinnaker Way City: Coronado State/Province: CA Postal code: 92118 Country: USA Email: B.W.Thomas@worldnet.att.net Home phone: 619-423-5213 Office phone: 619-972-5213 Fax: 619-575-4149
PROJECT BUDGET Explanation: For detailed information on what TRF funds, please see The Guide to Matching Grants (144-EN). Official RI exchange rates can be found at www.rotary.org/newsroom/downloadcenter/support/rates.html. Please use the most recent rate. Budget item Name of supplier Amount Passenger Van- Eurovan Emporio Automotriz Tijuana $27,339 Taxes, fees, licensing $2,936 Subtotal Exchange rate used US$1= Total in U.S. dollars $30,275
PROJECT FINANCING Explanation: Clearly list all financing in U.S. dollars noting which funds will be contributed in cash and which will be contributed from District Designated Funds (DDF). Use of DDF must be authorized by the district Rotary Foundation committee chair. TRF matches US$0.50 for every $1 cash contribution and $1 for every $1 contribution from DDF. The primary host club or district must provide at least $100. NOTE: No funds should be sent to TRF prior to official Trustee approval. Upon approval, a letter will be sent to the sponsors notifying them of approval and providing detailed instructions on how and where to submit their contributions. Host Rotary clubs or districts inside the project country (The primary host club or district must provide at least US$100.) Rotary Club of Ensenada Calafia $100 International Rotary clubs or districts outside the project country Rotary Club of Coronado $18,750 District 5430 DDF $1,000 Subtotal, Cash and DDF $18,850 $1,000 TOTAL Cosponsor contributions $19,850 Total funds requested from TRF (must be at least US$5,000) Additional outside funding (not matched by, or forwarded to, TRF) Total project financing (must equal budget on page 4) Cash (US$) DDF (US$) DRFC Chair (Print Name) DRFC Chair Authorization Cash (US$) DDF (US$) DRFC Chair (Print Name) DRFC Chair Authorization $10,425 - $30,275
PROJECT PLANNING Explanation: Before an application is submitted to TRF, project partners should discuss various planning details. The questions below are a guide to aid project planning. Note that a Rotary club/district or Rotarian may not own anything purchased with grant funds. Identify who will own equipment and maintain, operate, and secure items purchased with grant funds. (A Rotary club or Rotarian cannot own equipment.) Missionaries of the Cross Will training in use and maintenance of technical equipment be provided? If so, who will provide training? No Is software necessary to operate any items? If so, has software been provided? No Indicate what arrangements have been made for customs clearance if items will be purchased and shipped from outside the project country. Customs clearance unnecessary Provision of plumbing and electrification to structures where people live or work cannot be purchased with grant funds and must be funded with other sources. Have the sponsor clubs/districts planned and agreed to fund plumbing or electrification for equipment and appliances in existing buildings (hospitals, schools, libraries, orphanages, etc.)? Not Applicable COMPETITIVE GRANTS Explanation: Competitive grants are grants requesting US$25,001 or above from TRF. Additionally, all revolving loan or microcredit grants are competitive, regardless of the requested amount. Competitive grants are reviewed twice a year at the October and April Trustees meetings. If your grant request is for US$25,001 or above, a community needs assessment must be included. This assessment should demonstrate how the proposed project Involves the benefiting community Is viable and will be maintained by the benefiting community after grant funds have been expended If your project involves revolving loans or microcredit, additional information must be provided: Revolving Loan Fund Supplement Form Revolving Loan Fund Credit Group Plan Please refer to The Guide to Matching Grants (144-EN) and the RI Web site (www.rotary.org) for additional information.
AUTHORIZATION Explanation: Authorizations ensure that both partners are aware of, and interested in, pursuing the described project. By signing below, the current club presidents for club-sponsored projects and current district grants subcommittee chairs for district-sponsored projects, as well as the committee members, agree to the criteria listed and affirm their support of the project. All Rotary clubs, districts, and Rotarians involved in this project are responsible to The Rotary Foundation (TRF) for the conduct of the project and its subsequent reporting. The signatures of all involved parties confirm that they understand and accept responsibility for the project. Parties may either sign this page or submit a separate letter of commitment. By signing below, we agree to the following: All information contained in this application is, to the best of our knowledge, true and accurate, and we intend to implement the project as presented in this application. The club/district agrees to undertake this project as an activity of the club/district. We ensure all cash contributions (as detailed in Project Financing) will be forwarded to TRF or directly to the project account after Trustee approval of the grant. RI and TRF may use information contained in this application to promote the project by various means such as The Rotarian, the RI international convention, RVM: The Rotarian Video Magazine, etc. The partners agree to share information on best practices when asked, and TRF may provide partners contact information to other Rotarians who may wish advice on implementing similar projects. To the best of my knowledge and belief, except as disclosed herewith, neither I nor any person with whom I have or had a personal or business relationship is engaged, or intends to engage, in benefiting from TRF grant funds or has any interest that may represent a potential competing or conflicting interest. A conflict of interest is defined as a situation in which a Rotarian, in relationship to an outside organization, is in a position to influence the spending of TRF grant funds, or influence decisions in ways that could lead directly or indirectly to financial gain for the Rotarian, a business colleague, or his or her family, or give improper advantage to others to the detriment of TRF. (NOTE: Any and all exceptions must be explained in an attached statement.) Host Partner International Partner gfedcb gfedc Club president (club-sponsored) District grants subcommittee chair (district-sponsored) gfedcb gfedc Club president (club-sponsored) District grants subcommittee chair (district-sponsored) Name Luis Juarez Lujan Name Scott Metzger Title Club President Title Club President Rotary Club Ensenada Calafia Rotary Club Coronado District 4100 District 5430 Primary Contact Primary Contact Name M. Ofelia Diaz Perea Name Ron Vernetti Project Contact #2 Project Contact #2 Name LUIS JUAREZ LUJAN Name Dan Gensler Project Contact #3 Project Contact #3 Name ARTURO VILLAVICENCIO Name Barry Thomas
COMPLETION CHECKLIST Before submitting your Matching Grants Application, please take a moment to review this checklist. If you have any questions or concerns, please contact the humanitarian Grant Coordinator for the project location. gfedc Does the project meet all grant policies and guidelines (see The Guide to Matching Grants [144-EN] or the RI Web site at www.rotary.org)? gfedc Does the project description clearly state how the project will assist those in need? gfedc Are the activities of the host and international partners clearly explained? Will the Rotarians be actively involved in the project? gfedc Have both the host and international partners created committees to oversee the project? Are these individuals correctly listed on the application with their complete contact information? gfedc Is a detailed, itemized budget included in the application? gfedc Are all partner contributions listed in the application, noting which contributions will be cash and which will be DDF? gfedc Has the DRFC chair provided his/her signature authorizing the use of District Designated Funds? gfedc Have the club presidents or district grants subcommittee chairs from the host and international partner provided their authorizing signatures? gfedc Have all six committee members provided their authorizing signatures? gfedc If a cooperating organization is involved, are the following letters included with the application: gfedc Letter from the organization specifically stating its responsibilities, how it will interact with Rotarians, and agreeing to cooperate in any financial review of the project gfedc Letter of endorsement from the host partner confirming that the cooperating organization is reputable and works within the laws of that country gfedc If the project involves a revolving loan or microcredit, is the Revolving Loan Fund Supplement and Credit Group Plan included? gfedc If the grant request is US$25,001 or more, is a community needs assessment attached? gfedc Has the district grants subcommittee chair from either the host or international partner certified the application as complete and eligible? gfedc Is there a minimum of nine authorizing signatures included in the application? gfedc Have the partners made copies of all documents for their files prior to submitting them to TRF? Send the completed application and all attachments to: Humanitarian Grants Program The Rotary Foundation One Rotary Center 1560 Sherman Avenue Evanston, IL 60201-3698 USA Fax: 847-866-3698 Email: grants@rotary.org